Thursday, December 24, 2015

Clients of Street-Based Female Sex Workers & Potential Bridging of HIV/STI in Russia

In Russia, sexual transmission of HIV is increasing and street-based female sex workers (FSW) have a high HIV prevalence, but the role of male clients of FSW in HIV transmission and bridging to the general population has not been studied. 

Sixty-two male clients completed structured interviews during February-March of 2010 in St. Petersburg Russia. Descriptive analyses focused on condom use with different types of sex partners, substance use, and STI/HIV testing histories. 
  • The median lifetime and past 12 month numbers of FSW partners were 10 and 3, respectively. 
  • A majority of clients (74%) reported having non-FSW partners during the past 12 months, 
  • and nearly half (47%) reported having regular sex partners. 
  • Consistent condom use was reported in 61% of relationships with FSW partners 
  • and in 43% of relationships with non-FSW partners. 
  • A majority of clients (58%) was classified as active or potential bridgers based on having both FSW and non-FSW partners and reporting inconsistent condom use with their non-FSW partners. 
  • A majority (61%) also reported concurrent partnerships with FSW and non-FSW partners. 
  • Nearly half (48%) of last contacts with FSW partners involved consumption of alcohol by the client. 
  • Non-injection and injection drug use in the past 30 days were reported by 15% and 7% of clients, respectively. 
  • 29% reported history of an STI and 
  • 74% reported a previous HIV test; 
  • active/potential bridgers were significantly less likely than unlikely bridgers to have ever been tested for HIV. 

These data signal the potential for HIV/STI transmission among male clients of street-based FSW in St. Petersburg Russia due to their variety of partner types, sub-optimal condom use, and concurrent partnerships. Larger studies are needed to confirm these findings, further explore the roles of alcohol and drug use, and identify effective strategies and interventions for HIV prevention.

Below:  Distributions of bridging statusa, concurrencyb, and partner mixc in the past 12 months (n=62)

aDefinitions for bridging status variable are as follows: active bridging - reporting inconsistent condom use during vaginal sex with both FSW and non-FSW partners; potential bridging – reporting consistent condom use during vaginal sex with FSW partners and inconsistent condom use during vaginal sex with non-FSW partners; unlikely bridging – reporting consistent condom use during vaginal sex with FSW and non-FSW partners, or consistent condom use during vaginal sex with FSW and not having a non-FSW sex partner. One participant who reported consistent condom use during vaginal sex with non-FSW partner and inconsistent condom use during vaginal sex with FSW was classified as potential bridging. These categories were mutually exclusive. Participants with missing and “don’t know” responses to condom use questions were classified as inconsistent condom users because consistent condom use could not be verified.

bNot mutually exclusive categories.
cMutually exclusive categories

Full article at:

aYale School of Public Health and Center for Interdisciplinary Research on AIDS, 60 College Street, New Haven CT 06520 USA
bNGO Stellit, 3 Mira Street #207, St. Petersburg 197101 RUSSIA
*Corresponding author: Linda M. Niccolai, Email: ude.elay@ialoccin.adnil

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